abstracting & coding boot camp: cancer case scenarios camp 2016 slides updated.pdf · tnm...

Boot Camp 3/3/2016

NAACCR 2015‐2016 Webinar Series 1

2015-2016 NAACCR Webinar Series

Abstracting & Coding Boot Camp: Cancer Case Scenarios

Q&A

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• Please submit all questions concerning webinar content through the Q&A panel.

• Reminder:

• If you have participants watching this webinar at your site, please collect their names and emails.

• We will be distributing a Q&A document in about one week. This document will fully answer questions asked during the webinar and will contain any corrections that we may discover after the webinar.

Boot Camp 3/3/2016


Fabulous prizes

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Agenda

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• Updates

• Anatomy and Medical Terminology

• Data Items/Epi Moment

• Staging

• Break

• Treatment

• Review of Take Home Quizzes

Boot Camp 3/3/2016


2016 & 2017 Updates

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Stage Data Items

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• For cases diagnosed 2015 and earlier all CS data items are required

• Data items going away for cases diagnosed 2016 and after.• CS Ext

• CS Tumor Size

• CS Tumor Size/Ext Eval

• CS Lymph Nodes

• CS Lymph Nodes Eval

• CS Mets at DX

• CS Mets Eval

• CS Mets at Dx-Bone, Brain, Liver, Lung

Boot Camp 3/3/2016


New Stage Data Items

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• Tumor Size Summary (NPCR and CoC)• Tumor Size Clinical (SEER only)• Tumor Size Pathologic (SEER only)• Mets at Diagnosis - Distant Lymph Nodes• Mets at Diagnosis – Bone • Mets at Diagnosis – Brain • Mets at Diagnosis – Liver • Mets at Diagnosis – Lung • Mets at Diagnosis – Other

Stage Data Items

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• Data items we will continue to collect for cases diagnosed 2016 and forward.

• Regional Nodes Positive and Regional Nodes Examined

• CS Input Original and CS Input Current • These items are generated by your computer

• CS Site Specific Factors (SSF)• For 2016 CoC requires the same SSF’s as in 2015

• For 2016 SEER and NPCR have dropped some of the their requirements

• Lymph Vascular Invasion• For Penis and Testis schemas

Boot Camp 3/3/2016


TNM Classification Designator (c&p)

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• Beginning with cases abstracted using the v16 layout, a “c” or “p” classification designator will be added to all T, N, and M values.

• The designators indicate how the values entered into the T, N, and M data items were assigned.

• This will make it easier to show when a clinical value is used to determine a pathologic stage or when a pathologic value is used to determine a clinical stage.

TNM Classification Designator (c&p)

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• All cases diagnosed after 1/1/2016 will need to have a classification designator included in the T, N, or M values.

• CoC will require their reporting facilities to add the classification designators to the T, N, and M values to historical cases on their registry. They will also require that all cases abstracted after the v16 update include the classification indicators regardless of diagnosis year.

• State and regional registries will have to determine if they want cases diagnosed prior to 2016 to include the classification designators.

• In the central registry database• Incoming records

Boot Camp 3/3/2016


Updates

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• AJCC 8th Edition • Scheduled for release mid 2016

• Effective for cases diagnosed 2017 and forward

• FORDS 2016• https://www.facs.org/quality-

programs/cancer/ncdb/registrymanuals/cocmanuals/fordsmanual

• Cancer Program Standards 2016• https://www.facs.org/quality-programs/cancer/coc/standards

Updates

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• Summary Stage 2017• ICD O 3 Implementation • Solid Tumor Coding Manual and Solid Tumor Database

• Will replace the MP/H Manual

• Hematopoietic Database• SEER Rx

• The web-based version is updated in real time.• Stand alone version requires periodic updates (auto updates).

• NAACCR Vol II Appendix G- Recommended Abbreviations for Abstractors

• http://www.naaccr.org/Applications/ContentReader/Default.aspx?c=17

Boot Camp 3/3/2016


Revision of TNM Staged By Data Items

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• The length of the TNM Path Staged By and TNM Clin Staged By data items has been expanded to 2 digits to accommodate new codes.

• The historic 1 character codes will be converted to the new codes upon upgrade to NAACCR v16-compliant software.

Questions?

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Boot Camp 3/3/2016


Quiz 1

Anatomy and Medical Terminology

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Questions?

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Boot Camp 3/3/2016


Date of First RecurrenceType of First RecurrenceDate of Last ContactVital StatusCancer Status

Data Items : Outcomes

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Data Items: Outcomes

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• Date of First Recurrence• Measure the effectiveness of first course treatment

• Type of First Recurrence• Used to evaluate treatment effectiveness and as a long-term prognostic

factor

Boot Camp 3/3/2016


Date Items: Outcomes

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• Date of Last Contact• Used for patient follow-up and outcomes studies

• Vital Status• Verifies the vital status of patient as of the date entered in Date of last

Contact

• Cancer Status• Records if there is clinical evidence of the patients cancer as of the Date

of Last Contact

http://cancerbulletin.facs.org/forums/forum/fords-national-cancer-data-base/fords/treatment-outcomes/cancer-status/1306-cancer-status

(theme song of the moment…“I Will Survive”)

And now a brief pause for...

An Epi Moment20

Boot Camp 3/3/2016


Follow-up variables commonly used in research

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• Vital Status• Cause of death• Date last contact• Treatment• Treatment dates• Cancer status

• NCDB only

• Recurrence• NCDB only

Survival Analysis

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• Survival analysis is used to assess the success of cancer treatment programs and cancer control programs

• Required variables: vital status (or some other outcome like recurrence) and date of last follow-up (if not deceased or no recurrence) and cause of death

• Survival rate: summary variable-% of people alive after a given period of time

• Observed, expected, relative, cause-specific

• Survival curve• Censoring

Boot Camp 3/3/2016


Coming soon……

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• Inclusion criteria• Consent• CINA high quality data• SEER standard for follow-up

• 90% of patients have current follow-up dates (or deceased)

• 2005-2011-• follow-up dates Jan 1, 2012+

• OR state & national death linkages• 8 of 13 Canadian Provinces

• 63% national coverage• 1 no consent; 1 data quality not met

• 3 did not meet follow-up criteria

• 28 of 51 US states+ DC• 62% of US• 2 no consent; 3 data quality not met

• 18 did not meet follow-up criteria

Outcomes research

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• What treatment is effective?• Survival, interventions (screening and early diagnosis)

• Are standards of care followed?

• Comparative effectiveness research (CER)

• Impact of treatment delay

• Disparities in care• SES, insurance status or type, distance to care, regional or hospital

differences,

Boot Camp 3/3/2016


Recent publications

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1. Jemal A, Lin CC, DeSantic C, Sineshaw HM, Freedman RA. Temporal trends in and factors associated with receipt of contralateral prophylactic mastectomy among US men diagnosed with breast cancer. JAMA Surgery. 2015 Sep 2:3. Doi: 10.1001/jamasurg.2015.2657. PubMed AbsractFull Article

2. Seiber EE, Camacho F, Zeeshan MF, Kern TT, Fleming ST. Disparities in colorectal cancer treatment delay within Appalachia—The role of for-profit hospitals. J Rural Health, 2015. 31(4):382-91. PubMed Abstract

3. Fleming ST, Mackley HB, Camacho F, Seiber EE, Gusani NJ, Matthews SA, Liao J, Yang TC, Hwang W, Yao N. Clinical, sociodemographic, and service provider determinants of guideline concordant colorectal cancer care for Appalachian residents. J Rural Health;30(1):27-39. PubMed Abstract Full Article

4. Weir HK, Johnson CJ, Mariotto AB, Turner D, Wilson RJ, Nishri D, Ward KC. Evaluation of North American Association of Central Cancer Registries’ (NAACCR) data for use in population-based cancer survival studies. J. Natl Cancer Inst Monogr. 2014;49:198-209. PubMed Abstract Full Article

5. Edwards, B.K., et al., Annual Report to the Nation on the status of cancer, 1975-2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer, 2014. 120(9): p. 1290-314. PubMed Abstract Full Article

6. Boscoe, F.P., et al., Geographic proximity to treatment for early stage breast cancer and likelihood of mastectomy. Breast, 2011. 20(4): p. 324-8. PubMed Abstract Full Article

Questions?

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Boot Camp 3/3/2016


Quiz 2

Staging

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Break

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Boot Camp 3/3/2016


Quiz 3

Treatment

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Questions?

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Boot Camp 3/3/2016


MP/H

Staging

Take Home Quizzes

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Questions?

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Boot Camp 3/3/2016


Coming Up…

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• Collecting Cancer Data: Ovary• 4/7/16

• Collecting Cancer Data: Kidney• 5/5/16

Fabulous prizes

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Boot Camp 3/3/2016


CE Certificate Quiz/Survey

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• Phrase

Outcomes

• Link• http://www.surveygizmo.com/s3/2617467/Boot-Camp-2016

Jim Hofferkamp, CTR [email protected] Martin, CTR [email protected] Sherman, PhD, CTR [email protected]

Thank You!

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abstracting & coding boot camp: cancer case scenarios camp 2016 slides updated.pdf · tnm...

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